The effect of early life events on glucose levels in first-episode psychosis

Abstract

First episode of psychosis (FEP) patients display a wide variety of metabolic disturbances at onset, which might underlie these patients’ increased morbidity and early mortality. Glycemic abnormalities have been previously related to pharmacological agents; however, recent research highlights the impact of early life events. Birth weight (BW), an indirect marker of the fetal environment, has been related to glucose abnormalities in the general population over time. We aim to evaluate if BW correlates with glucose values in a sample of FEP patients treated with different antipsychotics. Two hundred and thirty-six patients were included and evaluated for clinical and metabolic variables at baseline and at 2, 6, 12, and 24 months of follow-up. Pearson correlations and linear mixed model analysis were conducted to analyze the data. Antipsychotic treatment was grouped due to its metabolic risk profile. In our sample of FEP patients, BW was negatively correlated with glucose values at 24 months of follow-up [r=-0.167, p=0.037]. BW showed a trend towards significance in the association with glucose values over the 24-month period (F=3.22; p=0.073) despite other confounders such as age, time, sex, body mass index, antipsychotic type, and chlorpromazine dosage. This finding suggests that BW is involved in the evolution of glucose values over time in a cohort of patients with an FEP, independently of the type of pharmacological agent used in treatment. Our results highlight the importance of early life events in the later metabolic outcome of patients.

Anthropometry in antipsychotic-naïve first-episode psychosis patients: An exploratory approach to the role of environmental early life events in two independent samples

“…Those patients affected by intrauterine stressful events are prone to develop metabolic abnormalities at earlier stages and so present reduced life-expectancy (Barker et al, 1989;Garcia-Rizo and Bitanihirwe, 2020;Kirkpatrick et al, 2008). Current literature highlights the impact of OCs in the metabolic (Garcia-Rizo et al, 2022;García-Rizo et al, 2020;Garriga et al, 2019a), cognitive (Amoretti et al, 2022), psychopathological (Mezquida et al, 2021;Sagué-Vilavella et al, 2022;Verdolini et al, 2023) and neurostructural (Costas-Carrera et al, 2020) outcome of patients with schizophrenia.…”

Obstetric complications and clinical presentation in first episode of psychosis

“…This model suggests that "undesirable conditions" during the perinatal period can have long-lasting metabolic consequences. Indeed, recent research showed that birth weight (BW), an indirect measure of the intrauterine milieu, is related to weight gain Garriga et al, 2019a) and glucose values in FEP (Garcia-Rizo et al, 2022), with T2DM in schizophrenia (Fernandez-Egea et al, 2020) and in affective disorders (Garriga et al, 2019b).…”